EFTA00723455

THE BREAKERS' 
PALM BEACH 
PAGE 
2 
PLAN 
CORP 
DRBORAH DAY 
1111111mr 
ROOM 
4175 
NNW 
10/31/2008 
DEPART 11/03/2008 PERSONS 
1 
GROUP 
FOLIOID: 397512533809 
TRANSFER FROM: 
CHARGES INCURRED ON YOUR DAY OF 
YOURA NOT BE REFLECTED ON THIS 
STATEMENT. THE CHARGES WILL BE APPLIED TO 
 CREDIT CARO RECEIVED AT CHECK 
IN. AN INVOICE WILL BE MAILED TO YOU FOR RICH DAY OF DEPARTURE CHARGES. 
GUEST 
SIGNATURE
SILL TO 
ADDRESS 
ALL AMOUNTS CHARGED ARE DUE UPON PRESENTATION OF YOUR Ba FAILURE TO PAY FOR 30 DAYS AFTER THE DUE DATE WILL RESULT IN ►IPOSTTION OF A FINANCE 
CHARGE. THE FINANCE CHARGE WILL BE APPLIED TO THE PORTION OF THE PREVIOUS BALANCE MORE THAN 30 DAYS 01.0 AND WILL BE COMPUTED AT THE RATE OF I 
112% ten MONTH. THIS IS AN ANNUAL PERCENTAGE RATE OP I OR. ALL. PAYMENTS AND CREDITS ARE DEDUCTED FROM THE PREVIOUS BALANCE PRIOR TO THE 
COMPUTATION OF THE FINANCE CHARGE. 
ONE SOUTH COUNTY ROAD I PALM BEACH. FLORIDA 33480 I P 
IF 
sA,WW.THE BR EA K ERS.COM 
EFTA00723515

IHE BREAKERS' 
PALM BEACH 
PAGE 
1 
PLAN 
CORP 
ROOM 
4173 
Ample 
10/31/2008 
Denim 11/03/2008 ftmon 
1 
KATHLEEN MCHUGH 
GROUP 
mum°, 3975225363.71 
TRANSFER FROM: 
DATE 
REFERENCE 
DESCRWTION 
AMOUNT 
10/31/2008 397519000135 
ROOM CHARGE 4173 
299.00 
TAX 
34.39 
11/01/2008 397529000192 
ROOM CHARGE 4173 
299.00 
TAX 
34.39 
11/02/2008 397532705008 
APPLIED DEPOSIT 
299.00-
***********5005 
11/02/2008 397539000263 
ROOM CHARGE 4173 
299.00 
TAX 
34.39 
/&n /7 ///96s.
CHARGES INCURRED ON YOUR DAY OF DEPARTURE MAY NOT BE AFFLICTED ON THIS 
STATEMENT. TM CHMIGES WILL RE APPLIED TO YOUR CREDIT CARD RECEIVED AT CHECK 
IN. AN INVOICE WILL SE MAILED TO YOU FOR SUCH DAY OF DEPIATURE CHARGES. 
GUEST 
SIGNATURE 
BILL TO 
ADDRESS 
TOTAL 
ALL AMOUNTS CHARGED ARE DUE UPON PRESENTATION Of YOUR BILL. FAILURE TO PAY FOR 30 DAYS AFTER THE DUE DATE WILL RESULT IN 1MPOSFTION OF A FINANCE 
CHARGE. THE FINANCE CHARGE WILL BE APPUED TO THE PORTION OF THE PREVIOUS SALANCE MOM THAN 30 DAYS 01.0 AND WILL BE COMPUTED AT THE RATE OF 1 
1/2% PER MONTH. THIS IS AN ANNUAL PERCENTAGE RATE OF 10%. ALL PAYMENTS AND CREDITS ARE DEDUCTED FROM THE PREVIOUS BALANCE PRIOR TO THE 
COMPUTATION OF THE FINANCE CHARGE. 
ONE SOUTH COUNTY ROAD F rAim BEACH. FLORIDA 33480 1 P 
F (561)659.8403 I www.THERREAKERS.COM 
EFTA00723516

/ 
• -••••,-•••••••./ 
4 aid 
• 
••11•••• •••••••%.11‘01/11 ••••• 
Psychological Affiliates, inc. 
Phone # 
Fax # 
I? 
X 
To: Amy Ederi, Esq. 
Fax number: 
Yl
{ 
Front: Evelyn/Dr. Day 
i 
i Date: I0/28/08 
1%
I Regarding: Payment for cases 
 
if 
l' 
Number of pagesonchuitng cover sheet): S 
i 
Comments: Our office policy is to be prepaid for evaluations such as these. Is it possible to 
overnight the checks? Thanks in advance. 
4A-J, 
IV) D60 
IF THERE ARE ANY PROBLEMS EN RECEIVING TSIS R 
SM SS ON, PLEASE CALL 
PSYCHOLOGICAL AFFILIATES AT 
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I
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entity named above. If you are not die intended recipient, you are hereby notified that any disclosure, 
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i is strictly prohibited. If you have received this facsimile in error, please immediately notify us by 
I, telephone to arrange for return of the original documents. 
EFTA00723517